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  • 邵黎明,孙成建*,徐锐,张伟,王彦华,赵晓龙.Onyx胶血管内栓塞治疗急性大咯血的临床效果[J].第二军医大学学报,2021,42(3):343-346    [点击复制]
  • SHAO Li-ming,SUN Cheng-jian*,XU Rui,ZHANG Wei,WANG Yan-hua,ZHAO Xiao-long.Clinical effect of Onyx endovascular embolization in treating acute massive hemoptysis[J].Acad J Sec Mil Med Univ,2021,42(3):343-346   [点击复制]
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Onyx胶血管内栓塞治疗急性大咯血的临床效果
邵黎明,孙成建*,徐锐,张伟,王彦华,赵晓龙
0
(青岛大学附属医院介入医学科, 青岛 266003
*通信作者)
摘要:
目的 探讨Onyx胶血管内栓塞治疗急性大咯血的安全性及有效性。方法 选取2015年3月至2017年8月因急性大咯血于我院接受Onyx胶血管内栓塞治疗的患者20例,男14例、女6例,中位年龄45.5(17~73)岁,支气管扩张10例、肺结核3例、肺癌2例、血管畸形1例、不明原因4例。其中10例为外院采用常规材料栓塞术后短期内(≤ 7 d)再次咯血。统计Onyx胶血管内栓塞治疗急性大咯血的技术成功率和临床成功率,分析相关并发症,并计算近期(<3个月)、中期(3~<12个月)及远期(≥ 12个月)复发率。结果 20例患者均成功进行栓塞,术后出血均得到有效控制,技术成功率与临床成功率均达100.0%(20/20)。所有患者均未出现脊髓损伤、呼吸衰竭等严重并发症。术后中位随访时间22.5(3~42)个月,18例(90.0%)患者随访12个月以上。3例患者分别于术后1、7、15个月复发,均经内科治疗有效,未再接受血管内栓塞止血治疗。2例肺癌患者分别于术后4、10个月死于原发性肿瘤。近期复发率为5.0%(1/20),中期复发率为5.0%(1/20),远期复发率为5.6%(1/18)。结论 采用Onyx胶血管内栓塞治疗急性大咯血安全、有效。
关键词:  Onyx胶  咯血  治疗性栓塞  介入性放射学
DOI:10.16781/j.0258-879x.2021.03.0343
投稿时间:2020-01-13修订日期:2020-09-17
基金项目:
Clinical effect of Onyx endovascular embolization in treating acute massive hemoptysis
SHAO Li-ming,SUN Cheng-jian*,XU Rui,ZHANG Wei,WANG Yan-hua,ZHAO Xiao-long
(Department of Interventional Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
*Corresponding author)
Abstract:
Objective To investigate the safety and efficacy of Onyx endovascular embolization in the treatment of acute massive hemoptysis. Methods Between Mar. 2015 and Aug. 2017, a total of 20 patients with acute massive hemoptysis received Onyx endovascular embolization in our hospital, including 14 males and 6 females, with a median age of 45.5 years (ranged 17-73 years), 10 cases of bronchiectasis, 3 cases of pulmonary tuberculosis, 2 cases of lung cancer, 1 case of arteriovenous malformation and 4 cases of cryptogenic hemoptysis. There were 10 cases experienced rebleeding after embolization with conventional agents within 7 days (transfered from other hospitals). The technical and clinical success rates and the related complications of Onyx endovascular embolization in treating acute massive hemoptysis were analyzed. The short-term (<3 months), medium-term (3-< 12 months) and long-term (≥ 12 months) recurrence rates were calculated. Results Embolization was technically and clinically successful in all the 20 patients (100.0%) and postoperative bleeding was effectively controlled. No serious complications such as spinal cord injury or respiratory failure occurred. The median follow-up time was 22.5 months (3-42 months), and 18 patients (90.0%) were followed up for more than 12 months. Three patients experienced recurrent hemoptysis at 1 month, 7 months and 15 months after initial embolization; all of them were treated effectively by internal medicine, and no further interventional hemostasis was given. Two cases died from the primary tumor of the lung at 4 months and 10 months after embolization. The recurrence rates of short-term (<3 months), medium-term (3-<12 months) and long-term (≥ 12 months) were 5.0% (1/20), 5.0% (1/20) and 5.6% (1/18), respectively. Conclusion Onyx endovascular embolization is safe and effective in the treatment of acute massive hemoptysis.
Key words:  Onyx  hemoptysis  therapeutic embolization  interventional radiology